National Trends in the Prevalence and Medical History of Angina: 1988 to 2012

Study Questions:

What are secular trends in self-reported angina from 1988 to 2012?

Methods:

This was a retrospective analysis of data from the National Health and Nutrition Examination Surgery (NHANES). The presence of angina was defined by medical history and the Rose questionnaire on angina (symptomatology). The authors calculated trends in both crude and standardized prevalence rates for self-reported angina.

Results:

From 2009 to 2012, there were on average 3.4 million (95% confidence interval, 2.8-4.0 million) people ages ≥40 years in the United States each year with angina (Rose questionnaire). For non-Hispanic whites, age- and sex-standardized rates for a medical history of angina declined significantly (p < 0.001) from 2001 to 2004 through 2009 to 2012. These rates did not change significantly for non-Hispanic blacks.

Conclusions:

While older non-Hispanic whites have experienced a decline in self-reported angina during the past 2 decades, the same improvement was not seen in non-Hispanic blacks.

Perspective:

This is an important study that adds to our understanding of the epidemiology of angina over the past 2 decades. The limitations of self-reported information aside, the present analysis points to racial disparities in the declining prevalence of angina symptoms and medical history of angina. Such disparities may be linked to similar disparities in the decline of cardiovascular risk factors (which have not declined among non-Hispanic blacks). Future studies should investigate and address these gaps.

Keywords: Prevalence, Ethnic Groups, European Continental Ancestry Group, Risk Factors, Questionnaires, Hispanic Americans, African Continental Ancestry Group, Nutrition Surveys


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